Key caveats flagged in the data: BELINDA was negative — tisagenlecleucel did not beat salvage + transplant in 2nd‑line lymphoma, so Kymriah has no 2nd‑line indication (unlike axi‑cel and liso‑cel). Axi‑cel’s follicular‑lymphoma indication is FDA‑only — the EMA declined it. Liso‑cel in CLL/SLL is FDA‑only. CTX110 (CARBON) was terminated for strategy, not safety. Satri‑cel (Claudin18.2) is a China‑only program — investigational in the US, and the only randomized success among the solid‑tumor programs. The rest of the solid‑tumor lane is phase 1 with limited durable benefit so far; EGFRvIII in glioblastoma is the canonical failure (antigen escape + adaptive resistance), and the celebrated IL13Rα2 glioblastoma remission was an exceptional case, not the cohort norm.
FDA vs EMA divergences: For adult B‑ALL, brexu‑cel and obe‑cel are approved for all adults (≥18) by FDA but only adults ≥26 y by EMA. The BCMA CAR‑Ts read “≥4 prior lines” (FDA) vs “≥3 prior therapies” (EMA) at first approval — real regulatory differences, not errors.
Not medical advice. Indication wording is summarised; consult current prescribing information and protocols. Investigational readouts (anito‑cel iMMagine‑1, arlo‑cel, cema‑cel ALPHA3, CTX112) rest on conference abstracts or topline press releases pending full publication. The in vivo (in‑situ) programs are the earliest of all — the CAR is generated inside the body, skipping apheresis and lymphodepletion; most are first‑in‑human with no efficacy data yet, and the two myeloma signals (ESO‑T01, KLN‑1010) are tiny, short‑follow‑up series (ESO‑T01 included a treatment‑associated death). Response rates across products are not head‑to‑head and reflect different diseases and populations.
NCCN layer. Preference‑tier and Category‑of‑Evidence labels are summarised across the disease‑specific
NCCN Guidelines (B‑Cell Lymphomas, ALL, CLL/SLL, and Multiple Myeloma; 2026 versions) and attributed to NCCN — not a reproduction. Each disease has its own guideline and update cycle; verify the live versions at
nccn.org. CAR‑T categories are summarised for orientation and may lag the current version.